Organization
MESOBEAUTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN A SORENSEN (COMPLIANCE CONSULTANT)
(602) 431-1152
Entity
Organization
Contact information
Practice address
21827 N SCOTTSDALE RD, SCOTTSDALE, AZ 85255-7443
(480) 821-6376
Mailing address
4919 E HAZEL DR, SUITE 1, PHOENIX, AZ 85044-7776
(602) 454-2144
(602) 431-2149
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
23328
AZ
Other
Enumeration date
10/06/2007
Last updated
07/17/2008
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